Individual
MADISON KANE BEARS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1029 W MAIN ST, LEBANON, TN 37087-3351
(615) 450-1659
Mailing address
1408 GREEN FOREST CT, MOUNT JULIET, TN 37122-6027
(615) 374-1962
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
36695
TN
Other
Enumeration date
06/25/2024
Last updated
07/24/2024
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